The Availability of Modified Ocular Trauma Score in Korean Patients with Open Globe Injury

Yong Il Shin; Yeon Hee Lee; Kyoung Nam Kim; Sung Bok Lee

doi:10.3341/jkos.2013.54.12.1902

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Shin, Lee, Kim, and Lee: The Availability of Modified Ocular Trauma Score in Korean Patients with Open Globe Injury

Original Article

J Korean Ophthalmol Soc 2013;54(12):1902-1906.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.12.1902

The Availability of Modified Ocular Trauma Score in Korean Patients with Open Globe Injury

Yong Il Shin, MD¹, Yeon Hee Lee, MD^1,², Kyoung Nam Kim, MD^1,², Sung Bok Lee, MD^1,^2,

¹Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea

²Research Institute for Biomedical Engineering, Chungnam National University, Daejeon, Korea

Address reprint requests to Sung Bok Lee, MD Department of Ophthalmology, Chungnam National University Hospital, #282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea, Tel: 82-42-280-7608, Fax: 82-42-255-3745, E-mail: sblee@cnu.ac.kr

Received 8 June 201322 June 2013 Accepted 8 October 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To modify the ocular trauma score (OTS) model by analyzing the clinical characteristics of Korean patients with open globe injury and to determine the availability of the modified OTS in predicting the final visual acuity.

Methods

Among the prognostic factors in the original OTS, endophthalmitis and perforating injury were excluded, and wound location, vitreous hemorrhage, lens damage, and lid laceration were added to the modified OTS based on the data of 242 patients with open globe injury from January 2000 to September 2010. To determine the availability of the modified OTS, 29 patients from September 2010 to December 2011, not included in the previous data, were retrospectively reviewed, and the positive and negative predictive values for assessment of final visual acuity less than 0.02 were calculated by the original and modified OTS.

Results

The modified OTS was applied to the previous data, and the positive predictive value was 75.3% and negative predictive value was 90.8%. By using the original OTS, the positive predictive value was 70.1% and negative predictive value was 89.8%. The values of the modified OTS was higher than those of the original OTS, but it was not statistically significant (p = 0.5956, p = 0.9370). When the modified OTS was applied to the new 29 patients, the positive and negative predictive values were 75.0% and 90.5%, respectively.

Conclusions

The prognostic factors of the original OTS were modified based on the previous data and the positive and negative predictive values of final visual acuity by modified OTS were similar to those by the original OTS. The modified OTS would be useful in analyzing the patients with open globe injuries and could be used as a prognostic model for Korean patients.

Keywords: Ocular trauma score, Open globe injury, Prognostic factors

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Table 1.

Original Ocualar Trauma Score (OTS) and modified OTS

Original OTS		Modified OTS
Factor	Raw points	Factor	Raw points
Initial visual acuity^*	60~100	Initial visual acuity^*	60~100
Rupture	-23	Afferent pupillary defect	-20
Endophthalmitis	-17	Rupture	-12
Perforating injury	-14	Retinal detachment	-11
Retinal detachment	-11	Lens damage	-5
Afferent pupillary defect	-10	Vitreous hemorrhage	-5
		Lid laceration	-5
		Wound location
		Corneosclera	-8
		Sclera ≥ 5 mm from limbus	-6
		Sclera < 5 mm from limbus	-4
		Cornea	0

^* NLP (No light perception) : 60, LP (Light perception) / HM (Hand movement) : 70, 1/200-19/200 : 80, 20/200-20-50 : 90, ≥ 20/40 : 100.

Table 2.

Category of raw points in original OTS and modified Ocular Trauma Scare

Category	Original OTS	Modified OTS
Category	Raw points	Raw points
1	0-44	0-37
2	45-65	38-52
3	66-80	53-73
4	81-91	74-84
5	92-100	85-100

Table 3.

Positive and negative predictive values of final visual acuity by original OTS and modified OTS in previous study

	Original OTS	Modified OTS	p-value
Positive predictive value	70.1%	75.3%	0.5956
Negative predictive value	89.8%	90.8%	0.9370

Table 4.

Demographics of the patients

Total number (eyes)	29
Age (years)	47.0 ± 8.7
Sex (Male : Female)	25 : 4

Values are presented as mean ± SD.

Table 5.

Category of final visual acuity by modified OTS

Modified OTS	Final visual acuity
Modified OTS	<0.02	≥0.02
Category 1	5	1
2	1	1
3	2	3
4	0	3
5	0	13

Table 6.

Positive and negative predictive value of final visual acuity by modified OTS in this study

	Modified OTS
Positive predictive value	75.0%
Negative predictive value	90.5%

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